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Efforts to establish safe injection facilities face pushback.

More than a dozen cities and states made efforts this year to establish safe injection facilities, locations where people who choose to consume controlled substances can do so in the presence of trained medical personnel who are prepared to respond to emergencies.Bobby Allyn, “Cities Planning Supervised Drug Injection Sites Fear Justice Department Reaction,” NPR, July 12, 2018; and Gordon, “What's The Evidence,” 2018.

At least 100 safe injection facilities operate worldwide, and researchers say that the presence of people who can provide injection advice and deploy breathing masks and even naloxone in crisis situations improves the health and safety of people who use drugs, while preventing overdoses.See Mary Clare Kennedy, Mohammad Karamouzian, and Thomas Kerr, “Public Health and Public Order Outcomes Associated with Supervised Drug Consumption Facilities: A Systematic Review,” Current HIV/AIDS Reports 14, no. 5 (2017), 161-83; and Gordon, “What's The Evidence,” 2018. In fact, no death has been reported at a safe injection facility to date, and such sites are associated with less outdoor drug use and more access to health services.Chloé Potier, Vincent Laprévote, Françoise Dubois-Arber, et al., “Supervised Injection Services: What Has Been Demonstrated? A Systematic Literature Review,” Drug and Alcohol Dependence 145, no. 1 (2014), 48-68, 62.

But safe injection facilities face stiff obstacles. In a New York Times op-ed, outgoing Deputy U.S. Attorney General Rod Rosenstein stated that the federal government considers such facilities to be in violation of the law, and that it would “meet the opening of any injection site with swift and aggressive action.”Rod Rosenstein, “Fight Drug Abuse, Don’t Subsidize It,” New York Times, August 27, 2018. Democrats have wavered on the issue too: California Governor Jerry Brown vetoed a bill authorizing safe injection facilities—just one month after Rosenstein’s editorial—halting momentum among nonprofits racing to establish a site in the state.Lopez, “The Trump Administration’s Threat Against Safe Injection Sites Is Working,” 2018; and Joshua Sabatini, “SF Loses Lead on Safe Injection Sites,” San Francisco Examiner, October 7, 2018. Before the veto, a consortium of San Francisco nonprofit organizations had prepared an example facility to showcase how they operate and what they can do to improve community safety and health.Sarah Holder, “A Controversial Fix for Overdose Deaths: Safe Injection Sites,” CityLab, September 5, 2018. And in New York City, Mayor Bill de Blasio’s promise to establish four facilities appears to be fading as Governor Andrew Cuomo and the New York State Department of Health waver on approving the plan. Jake Offenhartz, “What Ever Happened With Safe Injection Sites? Activists Blame Cuomo's 'Stalling,'” Gothamist, November 26, 2018.

With efforts elsewhere stalled, Philadelphia is poised to open the first safe injection facility in the country under the guidance of Ed Rendell, the former governor of Pennsylvania—and Philadelphia’s ex-mayor.Bobby Allyn, “'Come and Arrest Me': Former Pa. Governor Defies Justice Department On Safe Injection,” NPR, October 10, 2018. Rendell, who also oversaw the nation’s first syringe exchange, sits on the board of the nonprofit Safehouse, established to fund a safe injection facility without taxpayer dollars.Bobby Allyn, “'Come and Arrest Me': Former Pa. Governor Defies Justice Department On Safe Injection,” NPR, October 10, 2018. Despite threats of federal prosecution, Rendell remains undeterred. In response to Rosenstein’s editorial, Rendell suggested that Rosenstein “can come and arrest me.”Bobby Allyn, “'Come and Arrest Me': Former Pa. Governor Defies Justice Department On Safe Injection,” NPR, October 10, 2018.

If Philadelphia fails to open a safe injection facility, Denver is ready: the city council voted 12-1 in late November to approve a two-year pilot program, contingent on state legislation to provide criminal immunity for people who use the facility’s services.Jennifer Brown, “Denver Moves Forward with Plan for Supervised Injection Site for IV-Drug Users,” Colorado Sun, November 26, 2018.